Locomotor muscle fatigue modifies central motor drive in healthy humans and imposes a limitation to exercise performance

Exercise pressor responses are exaggerated relative to force production during, but not following, thirty-minutes of rhythmic handgrip exercise

PURPOSE

This study tested the hypothesis that blood pressure responses would increase relative to force production in response to prolonged bouts of muscular work.

METHODS

Fifteen individuals performed two minutes of static handgrip (SHG; 35% MVC), followed by three minutes of post-exercise-cuff-occlusion (PECO), before and after thirty minutes of rest (control), or rhythmic handgrip exercise (RHG) of the contralateral and ipsilateral forearms. Beat-by-beat recordings of mean arterial pressure (MAP), heart rate (HR), and handgrip force (kg) were averaged across one-minute periods at baseline, and minutes 5, 10, 15, 20, 25, and 30 of RHG. MAP was also normalized to handgrip force, providing a relative measure of exercise pressor responses (mmHg/kg). Hemodynamic responses to SHG and PECO were also compared before and after contralateral RHG, ipsilateral RHG, and control, respectively. Similar to the RHG trial, areas under the curve were calculated for MAP (blood pressure index; BPI) and normalized to the time tension index (BPInorm).

RESULTS

HR and MAP significantly increased during RHG (15.3 ± 1.4% and 20.4 ± 3.2%, respectively, both p < 0.01), while force output decreased by up to 36.6 ± 8.0% (p < 0.01). This resulted in a 51.6 ± 9.4% increase in BPInorm during 30 min of RHG (p < 0.01). In contrast, blood pressure responses to SHG and PECO were unchanged following RHG (all p ≥ 0.07), and only the mean HR (4.2 ± 1.5%, p = 0.01) and ΔHR (67.2 ± 18.1%, p < 0.01) response to SHG were exaggerated following ipsilateral RHG.

CONCLUSIONS

The magnitude of exercise pressor responses relative to force production progressively increases during, but not following, prolonged bouts of muscular work.

Acute performance fatigability following continuous versus intermittent cycling protocols is not proportional to total work done

Classical training theory postulates that performance fatigability following a training session should be proportional to the total work done (TWD); however, this notion has been questioned. This study investigated indices of performance and perceived fatigability after primary sessions of high-intensity interval training (HIIT) and constant work rate (CWR) cycling, each followed by a cycling time-to-task failure (TTF) bout. On separate days, 16 participants completed an incremental cycling test, and, in a randomized order, (i) a TTF trial at 80% of peak power output (PPO), (ii) an HIIT session, and (iii) a CWR session, both of which were immediately followed by a TTF trial at 80% PPO. Central and peripheral aspects of performance fatigability were measured using interpolated twitch technique, and perceptual measures were assessed prior to and following the HIIT and CWR trials, and again following the TTF trial. Despite TWD being less following HIIT (P = 0.029), subsequent TTF trial was an average of 125 s shorter following HIIT versus CWR (P < 0.001), and this was accompanied by greater impairments in voluntary and electrically evoked forces (P < 0.001), as well as exacerbated perceptual measures (P < 0.001); however, there were no differences in any fatigue measure following the TTF trial (P ≥ 0.149). There were strong correlations between the decline in TTF and indices of peripheral (r = 0.70) and perceived fatigability (r ≥ 0.80) measured at the end of HIIT and CWR. These results underscore the dissociation between TWD and performance fatigability and highlight the importance of peripheral components of fatigability in limiting endurance performance during high-intensity cycling exercise.

Peripheral fatigue regulation during knee extensor exercise in type 1 diabetes and consequences on the force-duration relationship

PURPOSE

This study aimed to examine if peripheral fatigue is adjusted during knee extensor (KE) exercise in order not to surpass a critical threshold patient with type 1 diabetes (T1D) and the consequences of this mechanism on the force-duration relationship.

METHODS

Eleven T1D individuals randomly performed two different sessions in which they performed 60 maximum voluntary contractions (MVC; 3 s contraction, 2 s relaxation). One trial was performed in the non-fatigued state (CTRL) and another after fatiguing neuromuscular stimulation of the KE (FNMES). Peripheral and central fatigue were quantified by the difference between pre and post exercise in quadriceps voluntary activation (ΔVA) and potentiated twitch (ΔPtw). Critical torque (CT) was determined as the average force of the last 12 contractions, whereas W' was calculated as the area above the CT.

RESULTS

Although FNMES led to a significant decrease in potentiated twitch (Ptw) before performing the 60-MVCs protocol (p < 0.05), ΔVA (∼ -7.5%), ΔPtw (∼ -39%), and CT (∼816 N) post-MVCs were similar between the two conditions. The difference in W' between CTRL and FNMES was correlated with the level of pre-fatigue induced in FNMES (r2 = 0.60). In addition, W' was correlated with ΔPtw (r2 = 0.62) in the CTRL session.

CONCLUSION

Correlative results in the present study indicate that regulating peripheral fatigue mechanisms at a critical threshold limit W'. Additionally, peripheral fatigue during KE exercise is limited to an individual threshold in T1D patients.

Recovery following exercise-induced fatigue: Influence of a single heart rate clamped cycling session under systemic hypoxia

We investigated whether a single heart rate clamped cycling session under systemic hypoxia affects the recovery of physical and psycho-physiological responses from residual fatigue compared to normoxia. On separate occasions, twelve trained males performed a 3-d acute training camp scenario. On days 1 and 3, participants cycled for 60 min at a constant heart rate (80% of ventilatory threshold). On day 2, fatigue was induced through a simulated team game circuit (STGC), followed by a 60-min intervention of either: (1) heart rate clamped cycling in normoxia; (2) heart rate clamped cycling in hypoxia (simulated altitude ~ 3500 m); or (3) no cycling. Countermovement jump height and leg stiffness were assessed before and after every session. Perceptual fatigue was evaluated daily. Compared to baseline, jump height decreased at all timepoints following the STGC (all p < 0.05). Leg stiffness and cycling power output only decreased immediately following the STGC, with a 48% further decrease in cycling power output in hypoxia compared to normoxia (p < 0.05). Perceived fatigue, decreased sleep quality, and increased muscle soreness responses occurred on day 3 (p < 0.05). A single heart rate-clamped cycling session in hypoxia reduced mechanical output without affecting recovery of physical performance and perceptual measures from residual fatigue induced through team sport activity.

Is the Lung Built for Exercise? Advances and Unresolved Questions

ABSTRACT

Nearly 40 yr ago, Professor Dempsey delivered the 1985 ACSM Joseph B. Wolffe Memorial Lecture titled: "Is the lung built for exercise?" Since then, much experimental work has been directed at enhancing our understanding of the functional capacity of the respiratory system by applying complex methodologies to the study of exercise. This review summarizes a symposium entitled: "Revisiting 'Is the lung built for exercise?'" presented at the 2022 American College of Sports Medicine annual meeting, highlighting the progress made in the last three-plus decades and acknowledging new research questions that have arisen. We have chosen to subdivide our topic into four areas of active study: (i) the adaptability of lung structure to exercise training, (ii) the utilization of airway imaging to better understand how airway anatomy relates to exercising lung mechanics, (iii) measurement techniques of pulmonary gas exchange and their importance, and (iv) the interactions of the respiratory and cardiovascular system during exercise. Each of the four sections highlights gaps in our knowledge of the exercising lung. Addressing these areas that would benefit from further study will help us comprehend the intricacies of the lung that allow it to meet and adapt to the acute and chronic demands of exercise in health, aging, and disease.

Evaluation of the c-Fos expression in the hippocampus after fatigue caused by one session of endurance exercise in pre-pubertal and adult rats

PURPOSE

Central fatigue plays an important role in reducing endurance exercise activity during brain development. c-Fos gene expression in the hippocampus was examined as an indicator of neuronal activation after exhaustion.

METHODS

Eighteen pre-pubertal male rats at four weeks old and 18 adult rats at eight weeks were randomly divided into three groups: Control (C), Constant time exercise (CTEx), Endurance Exercise until Exhaustion (ExhEx), which started at two minutes and ended in 20 min, the main swimming test was performed with a weight equal to 5% of the bodyweight attached to the rats' tail as a single session in experimental groups and was recorded at the end of their time, while to evaluate the force loss, the Grip strength was measured before and after the activity. The brain activation rate was examined by c-Fos gene expression and Nissl staining in CA3 and dentate gyrus (DG) in the hippocampus of all groups.

RESULTS

Power grip and Nissl positive neurons in CA3 and DG have been significantly higher in pre-pubertal rats than in adults, both in the CTEx group (p = 0.04) and in the ExhEx group (p < 0.001). Also, real-time exhaustion in the pre-pubertal group was significantly longer than in adults. c-Fos gene expression was significantly reduced in adults' hippocampus in comparison to preadolescence (p < 0.01) and control (p < 0.001).

CONCLUSION

These findings clarified that increased strength and longer fatigue in pre-puberal rats may lead to c-Fos gene expression and decreased neurons in the hippocampus. Perhaps this is a protective effect to suppress stress hormones.

Medium chain triglycerides with a C8:C10 ratio of 30:70 enhances cognitive performance and mitigates the cognitive decline associated with prolonged exercise in young and healthy adults

INTRODUCTION

Prolonged exercise has been linked to a decline in cognitive function due to a variety of factors, such as a drop in oxygen in the prefrontal cortex and an increase in stress hormones and neurotransmitters. Medium chain triglycerides (MCTs) may possibly offset this decline as they provide energy for the brain via both direct and indirect pathways, alongside promoting chronic physiological adaptations within the brain.

METHODS

Participants were divided into two groups; MCT (n = 9) and Placebo (n = 10). The MCT gels contained 6 g of MCT with a C8:C10 ratio of 30:70, whereas the placebo gels contained carbohydrates of similar calorific value to the MCT gels. Participants visited the laboratory on three occasions (familiarisation/fitness test, pre-supplementation, post-supplementation), during which they performed a battery of cognitive tasks assessing domains such as processing speed, working memory, selective attention, decision making and coordination, before and after a prolonged bout of exercise (60 mins at 90% gas exchange threshold (GET). A 2-week supplementation period between visits 2 and 3 involved the ingestion of 2 gels per day.

RESULTS

Exercise resulted in detriments in most cognitive tasks pre-supplementation for both groups, and post-supplementation for the Placebo group (main effect ps< 0.05). Post-supplementation, the effect of exercise was mediated in the MCT group for all cognitive tasks (main effect ps< 0.05), except for the Digit and Spatial Span Backwards test phases (main effect ps> 0.05). Furthermore, MCT supplementation enhanced before-exercise cognitive performance and in some measures, such as working memory, this was maintained after-exercise (interaction effect ps> 0.05).

CONCLUSIONS

Chronic MCT supplementation enhanced before-exercise cognitive performance and offset the cognitive decline caused by a prolonged bout of exercise. In some cases, improvements in before-exercise cognitive performance were maintained after-exercise.

Altitude-induced effects on neuromuscular, metabolic and perceptual responses before, during and after a high-intensity resistance training session

PURPOSE

We tested if an acute ascending to 2320 m above sea level (asl) affects corticospinal excitability (CSE) and intracortical inhibition (SICI) measured with transcranial magnetic stimulation (TMS) at rest, before, during and after a traditional hypertrophy-oriented resistance training (RT) session. We also explored whether blood lactate concentration (BLa), ratings of perceived exertion (RPE), perceived muscular pain and total training volume differed when the RT session was performed at hypoxia (H) or normoxia (N).

METHODS

Twelve resistance-trained men performed eight sets of 10 repetitions at 70% of one repetition maximum of a bar biceps curl at N (SpO2 = 98.0 ± 0.9%) and H (at 2320 asl, SpO2 = 94.0 ± 1.9%) in random order. Before each session, a subjective well-being questionnaire, the resting motor threshold (rMT) and a single pulse recruitment curve were measured. Before, during and after the RT session, BLa, RPE, muscle pain, CSE and SICI were measured.

RESULTS

Before the RT session only the rMT differed between H (- 5.3%) and N (ES = 0.38). RPE, muscle pain and BLa increased through the RT session and were greater at H than N (12%, 54% and 15%, respectively) despite a similar training volume (1618 ± 468 kg vs. 1638 ± 509 kg). CSE was reduced during the RT session (~ 27%) but recovered ten minutes after, regardless of the environmental condition. SICI did not change after any RT session.

CONCLUSIONS

The data suggest that acute exposure to moderate hypoxia slightly increased the excitability of the most excitable structures of the corticospinal tract but did not influence intracortical or corticospinal responses to a single RT session.

Three weeks of mental training changes physiological outcomes during a time trial to exhaustion

Mental training (MT) can increase endurance performance. The purpose of this study was to examine the minimum dose of mental training needed to increase performance and elucidate the physiological mechanisms underlying this improvement. In a randomized between groups pre-test-post-test design, 33 participants visited the lab on 6 separate days. A VO2peak with ventilatory threshold (VT) was performed on day 1. The subsequent visits consisted of time trials to exhaustion (TTE) performed at 10% above VT. Between visit 3 and 6, the MT group (n = 16) watched a video for 10-15 min each day for 3 weeks, while the control group (CON; n = 17) did no mental training. Heart rate (HR), rate of perceived exertion (RPE), VAS scores for pain and fatigue, electromyography, and metabolic and neuromuscular data were collected and recorded during the time trials. The GRIT-S and CD-RISC 10 surveys were completed before study days 3 and 6. TTE increased significantly for MT beginning after 2 weeks (10.0 ± 13.1%) with no further change after 3 weeks (10.4 ± 13.2). TTE also significantly decreased during the last TTE for CON (-10.3 ± 12.7). VO2, ventilation, and frequency of breathing were significantly reduced in the latter stages of the TTE for MT. EMG was also significantly decreased for MT as compared for CON throughout the trial. Three weeks of mental training improves performance by reducing EMG, decreasing activation of the muscle and reducing metabolic factors during the latter stages of exercise.

Performance Kinetics During Repeated Sprints is Influenced by Knowledge of Task Endpoint and Associated Peripheral Fatigue

The regulation of exercise intensity allows an athlete to perform an exercise in the fastest possible time while avoiding debilitating neuromuscular fatigue development. This phenomenon is less studied during intermittent activities. To investigate anticipatory and real-time regulation of motor output and neuromuscular fatigue during repeated-sprint exercise, twelve males randomly performed one (S1), two (S2), four (S4) and six (S6) sets of five 5-s cycling sprints. Mechanical work and electromyographic activity were assessed during sprints. Potentiated quadriceps twitch force (ΔQtw,pot) and central activation ratio (QCAR) were quantified from response to supra-maximal magnetic femoral nerve stimulation pre-vs post-exercise. Compared with S1, mechanical work developed in the first sprint and in the entire first set was reduced in S6 (-7.8% and -5.1%, respectively, P < 0.05). Work developed in the last set was similar in S4 and S6 (P = 0.82). Similar results were observed for EMG activity. The QCAR was also more reduced in S4 (-5.8%, P < 0.05) and S6 (-8.3%, P < 0.05) than in S1. However, ΔQtw,pot was not significantly different across all trials (-33.1% to -41.9%, P = 0.46). Perceived exhaustion increased across sprints to reach a maximal and similar level in S2, S4 and S6 (all 19.2, P < 0.01 vs S1). These results suggest that the regulation of performance, exerted at the beginning and continuously during repeated sprints, is based on the task endpoint, presumably to avoid excessive peripheral muscle and associated conscious overwhelming sensations.

Blood flow restriction during high-intensity interval cycling exacerbates psychophysiological responses to a greater extent in females than males

This study aimed to characterize neuromuscular, perceptual, and cardiorespiratory responses to high-intensity interval training (HIIT) with superimposed blood flow restriction in males and females. Twenty-four, healthy individuals (n = 12 females) completed two cycling HIIT protocols to task failure (1-min work phases at 90% of peak power output interspersed by 1-min rest phases). The blood flow restriction (BFR) and control (CON) protocols were identical except for the presence and absence of BFR during rest phases, respectively. The interpolated twitch technique, including maximal voluntary isometric knee extension (MVC) and femoral nerve electrical stimuli, was performed at baseline, every six intervals, and task failure. Perceptual and cardiorespiratory responses were recorded every three intervals and continuously during exercise, respectively. Bayesian inference was used to obtain the joint posterior distribution for all parameters and evidence of an effect was determined via the marginal posterior probability (PP). The BFR shortened task duration by 57.3% compared with CON (PP > 0.99), without a sex difference. The application of BFR exacerbated the rate of decline in neuromuscular measures (MVC and twitch force output), increase of perceptual responses (perceived effort, pain, dyspnea, fatigue), and development of cardiorespiratory parameters (minute ventilation and heart rate), compared with CON (PP > 0.95). In addition, BFR exacerbated the neuromuscular, perceptual, and cardiorespiratory responses to a greater extent in females than males (PP > 0.99). Our results suggest that superimposition of blood flow restriction exacerbates psychophysiological responses to a HIIT protocol to a greater extent in females than males.NEW & NOTEWORTHY To our knowledge, no study has explored sex differences in the neuromuscular, perceptual, and cardiorespiratory indices characterizing exercise tolerance during high-intensity interval training (HIIT) with blood flow restriction (BFR) applied only during rest periods. Our results suggest that BFR elicited a decline in exercise performance that could be attributed to integration of psychophysiological responses. However, this integration was sex-dependent where females demonstrated an exacerbated rate of change in these responses compared with males.

Measuring objective fatigability and autonomic dysfunction in clinical populations: How and why?

Fatigue is a major symptom in many diseases, often among the most common and severe ones and may last for an extremely long period. Chronic fatigue impacts quality of life, reduces the capacity to perform activities of daily living, and has socioeconomical consequences such as impairing return to work. Despite the high prevalence and deleterious consequences of fatigue, little is known about its etiology. Numerous causes have been proposed to explain chronic fatigue. They encompass psychosocial and behavioral aspects (e.g., sleep disorders) and biological (e.g., inflammation), hematological (e.g., anemia) as well as physiological origins. Among the potential causes of chronic fatigue is the role of altered acute fatigue resistance, i.e. an increased fatigability for a given exercise, that is related to physical deconditioning. For instance, we and others have recently evidenced that relationships between chronic fatigue and increased objective fatigability, defined as an abnormal deterioration of functional capacity (maximal force or power), provided objective fatigability is appropriately measured. Indeed, in most studies in the field of chronic diseases, objective fatigability is measured during single-joint, isometric exercises. While those studies are valuable from a fundamental science point of view, they do not allow to test the patients in ecological situations when the purpose is to search for a link with chronic fatigue. As a complementary measure to the evaluation of neuromuscular function (i.e., fatigability), studying the dysfunction of the autonomic nervous system (ANS) is also of great interest in the context of fatigue. The challenge of evaluating objective fatigability and ANS dysfunction appropriately (i.e.,. how?) will be discussed in the first part of the present article. New tools recently developed to measure objective fatigability and muscle function will be presented. In the second part of the paper, we will discuss the interest of measuring objective fatigability and ANS (i.e. why?). Despite the beneficial effects of physical activity in attenuating chronic fatigue have been demonstrated, a better evaluation of fatigue etiology will allow to personalize the training intervention. We believe this is key in order to account for the complex, multifactorial nature of chronic fatigue.

Characterization of muscle recruitment during gait of bilateral transfemoral and through-knee persons with limb loss

Introduction: Due to loss in musculoskeletal capacity, there is an increased burden on the residual limbs of bilateral transfemoral and through-knee persons with limb loss. This reduced capacity is associated with an increased cost of walking that is detrimental to functionality. Compensatory gait strategies are adopted by this population. However, how these strategies relate to specific muscle recruitment is not known. The primary aim of this study is to characterize muscle recruitment during gait of this population. The secondary aim is to assess whether the measured kinematics can be actuated when the endurance of specific muscles is reduced and if this is the case, which alternative muscles facilitate this. Methods: 3D gait data and high-resolution magnetic resonance images were acquired from six bilateral transfemoral and through-knee persons with limb loss. Subject-specific anatomical muscle models were developed for each participant, and a validated musculoskeletal model was used to quantify muscle forces in two conditions: during normal gait (baseline) and when muscles, which were identified as functioning above a "healthy" level at baseline, have a reduced magnitude of maximum force capacity (reduced endurance simulation). To test the hypothesis that there are differences in muscle forces between the baseline trials and the simulations with reduced muscular endurance, a Bonferroni corrected two-way ANOVA with repeated measures was completed between the two states. Results: The baseline analysis showed that the hip flexors experience relatively high muscle activations during gait. The reduced endurance simulation found two scenarios. First, for 5 out of the 12 simulations, the baseline kinematics could not be reproduced with the reduced muscular capacity. Second, for 7 out of 12 cases where the baseline kinematics were achieved, this was possible with compensatory increased activation of some muscles with similar functions (p ≤ 0.003). Discussion: Evidently, due to the loss of the ankle plantar flexors, gait imposes a high demand on the flexor muscle group of the residual limb. This study highlights how the elevated cost of gait in this population manifests in muscle recruitment. To enhance functionality, it is critical to consider the mechanical demand on the hip flexors and to develop rehabilitation interventions accordingly.

A 10-mg dose of amiloride increases time to failure during blood-flow-restricted plantar flexion in healthy adults without influencing blood pressure

Amiloride has been shown to inhibit acid-sensing ion channels (ASICs), which contribute to ischemia-related muscle pain during exercise. The purpose of this study was to determine if a single oral dose of amiloride would improve exercise tolerance and attenuate blood pressure during blood-flow-restricted (BFR) exercise in healthy adults. Ten subjects (4 females) performed isometric plantar flexion exercise with BFR (30% maximal voluntary contraction) after ingesting either a 10-mg dose of amiloride or a volume-matched placebo (random order). Time to failure, time-tension index (TTI), and perceived pain (visual analog scale) were compared between the amiloride and placebo trials. Mean blood pressure, heart rate, blood pressure index (BPI), and BPI normalized to TTI (BPInorm) were also compared between trials using both time-matched (TM50 and TM100) and effort-matched (T50 and T100) comparisons. Time to failure (+69.4 ± 63.2 s, P < 0.01) and TTI (+1,441 ± 633 kg·s, P = 0.02) were both significantly increased in the amiloride trial compared with placebo, despite no increase in pain (+0.4 ± 1.7 cm, P = 0.46). In contrast, amiloride had no significant influence on the mean blood pressure or heart rate responses, nor were there any significant differences in BPI or BPInorm between trials when matched for time (all P ≥ 0.13). When matched for effort, BPI was significantly greater in the amiloride trial (+5,300 ± 1,798 mmHg·s, P = 0.01), likely owing to an increase in total exercise duration. In conclusion, a 10-mg oral dose of amiloride appears to significantly improve the tolerance to BFR exercise in healthy adults without influencing blood pressure responses.

The Neuromuscular Fatigue-Induced Loss of Muscle Force Control

Neuromuscular fatigue is characterised not only by a reduction in the capacity to generate maximal muscle force, but also in the ability to control submaximal muscle forces, i.e., to generate task-relevant and precise levels of force. This decreased ability to control force is quantified according to a greater magnitude and lower complexity (temporal structure) of force fluctuations, which are indicative of decreased force steadiness and adaptability, respectively. The “loss of force control” is affected by the type of muscle contraction used in the fatiguing exercise, potentially differing between typical laboratory tests of fatigue (e.g., isometric contractions) and the contractions typical of everyday and sporting movements (e.g., dynamic concentric and eccentric contractions), and can be attenuated through the use of ergogenic aids. The loss of force control appears to relate to a fatigue-induced increase in common synaptic input to muscle, though the extent to which various mechanisms (afferent feedback, neuromodulatory pathways, cortical/reticulospinal pathways) contribute to this remains to be determined. Importantly, this fatigue-induced loss of force control could have important implications for task performance, as force control is correlated with performance in a range of tasks that are associated with activities of daily living, occupational duties, and sporting performance.

Excess ventilation and exertional dyspnoea in heart failure and pulmonary hypertension

Increased ventilation relative to metabolic demands, indicating alveolar hyperventilation and/or increased physiological dead space (excess ventilation), is a key cause of exertional dyspnoea. Excess ventilation has assumed a prominent role in the functional assessment of patients with heart failure (HF) with reduced (HFrEF) or preserved (HFpEF) ejection fraction, pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). We herein provide the key pieces of information to the caring physician to 1) gain unique insights into the seeds of patients' shortness of breath and 2) develop a rationale for therapeutically lessening excess ventilation to mitigate this distressing symptom. Reduced bulk oxygen transfer induced by cardiac output limitation and/or right ventricle-pulmonary arterial uncoupling increase neurochemical afferent stimulation and (largely chemo-) receptor sensitivity, leading to alveolar hyperventilation in HFrEF, PAH and small-vessel, distal CTEPH. As such, interventions geared to improve central haemodynamics and/or reduce chemosensitivity have been particularly effective in lessening their excess ventilation. In contrast, 1) high filling pressures in HFpEF and 2) impaired lung perfusion leading to ventilation/perfusion mismatch in proximal CTEPH conspire to increase physiological dead space. Accordingly, 1) decreasing pulmonary capillary pressures and 2) mechanically unclogging larger pulmonary vessels (pulmonary endarterectomy and balloon pulmonary angioplasty) have been associated with larger decrements in excess ventilation. Exercise training has a strong beneficial effect across diseases. Addressing some major unanswered questions on the link of excess ventilation with exertional dyspnoea under the modulating influence of pharmacological and nonpharmacological interventions might prove instrumental to alleviate the devastating consequences of these prevalent diseases.

Prior Involvement of Central Motor Drive Does Not Impact Performance and Neuromuscular Fatigue in a Subsequent Endurance Task

PURPOSE

This study evaluated whether central motor drive during fatiguing exercise plays a role in determining performance and the development of neuromuscular fatigue during a subsequent endurance task.

METHODS

On separate days, 10 males completed three constant-load (80% peak power output), single-leg knee-extension trials to task failure in a randomized fashion. One trial was performed without preexisting quadriceps fatigue (CON), and two trials were performed with preexisting quadriceps fatigue induced either by voluntary (VOL; involving central motor drive) or electrically evoked (EVO; without central motor drive) quadriceps contractions (~20% maximal voluntary contraction (MVC)). Neuromuscular fatigue was assessed via pre-post changes in MVC, voluntary activation (VA), and quadriceps potentiated twitch force ( Qtw,pot ). Cardiorespiratory responses and rating of perceived exertion were also collected throughout the sessions. The two prefatiguing protocols were matched for peripheral fatigue and stopped when Qtw,pot declined by ~35%.

RESULTS

Time to exhaustion was shorter in EVO (4.3 ± 1.3 min) and VOL (4.7 ± 1.5 min) compared with CON (10.8 ± 3.6 min, P < 0.01) with no difference between EVO and VOL. ΔMVC (EVO: -47% ± 8%, VOL: -45% ± 8%, CON: -53% ± 8%), Δ Qtw,pot (EVO: -65% ± 7%, VOL: -59% ± 14%, CON: -64% ± 9%), and ΔVA (EVO: -9% ± 7%, VOL: -8% ± 5%, CON: -7% ± 5%) at the end of the dynamic task were not different between conditions (all P > 0.05). Compared with EVO (10.6 ± 1.7) and CON (6.8 ± 0.8), rating of perceived exertion was higher ( P = 0.05) at the beginning of VOL (12.2 ± 1.0).

CONCLUSIONS

These results suggest that central motor drive involvement during prior exercise plays a negligible role on the subsequent endurance performance. Therefore, our findings indicate that peripheral fatigue-mediated impairments are the primary determinants of high-intensity single-leg endurance performance.

Impaired regenerative capacity contributes to skeletal muscle dysfunction in chronic obstructive pulmonary disease

Locomotor skeletal muscle dysfunction is a relevant comorbidity of chronic obstructive pulmonary disease (COPD) and is strongly associated with worse clinical outcomes including higher mortality. Over the last decades, a large body of literature helped characterize the process, defining the disruptive muscle phenotype caused by COPD that involves reduction in muscle mass, force-generation capacity, fatigue-tolerance, and regenerative potential following injury. A major limitation in the field has been the scarcity of well-calibrated animal models to conduct mechanistic research based on loss- and gain-of-function studies. This article provides an overall description of the process, the tools available to mechanistically investigate it, and the potential role of mitochondrially driven metabolic signals on the regulation muscle regeneration after injury in COPD. Finally, a description of future avenues to further expand on the area is proposed based on very recent evidence involving mitochondrial metabolic cues affecting myogenesis.

Time Course of Performance Fatigability during Exercise below, at, and above the Critical Intensity in Females and Males

PURPOSE

This study aimed to investigate the time course and amplitude of performance fatigability during cycling at intensities around the maximal lactate steady state (MLSS) until task failure (TTF).

METHODS

Ten females and 11 males were evaluated in eight visits: 1) ramp incremental test; 2-3) 30-min constant power output (PO) cycling for MLSS determination; and 4-8) cycling to TTF at PO relative to the MLSS of (i) -15%, (ii) -10 W, (iii) at MLSS, and (iv) +10 W, and (v) +15%. Performance fatigability was characterized by femoral nerve electrical stimulation of knee extensors at baseline; minutes 5, 10, 20, and 30; and TTF. Oxygen uptake, blood lactate concentration, muscle oxygen saturation, and perceived exertion were evaluated.

RESULTS

Approximately 75% of the total performance fatigability occurred within 5 min of exercise, independently of exercise intensity, followed by a further change at minute 30. Contractile function declined more in males than females (all P < 0.05). At task failure, exercise duration declined from MLSS -15% to MLSS +15% (all P < 0.05), accompanied by a greater rate of decline after MLSS +15% and MLSS +10 compared with MLSS, MLSS -10 , and MLSS -15% for voluntary activation (-0.005 and -0.003 vs -0.002, -0.001 and -0.001%·min -1 , respectively) and contractile function (potentiated single twitch force, -0.013 and -0.009 vs -0.006, -0.004 and -0.004%·min -1 , respectively).

CONCLUSIONS

Whereas the time course of performance fatigability responses was similar regardless of exercise intensity and sex, the total amplitude and rate of change were affected by the distinct metabolic disturbances around the MLSS, leading to different performance fatigability etiologies at task failure.

Relationship between perceived and neuromuscular fatigue in COPD patients with chronic respiratory failure with long-term oxygen therapy: a cross-sectional study

PURPOSE

To evaluate perceived fatigue (PF) and neuromuscular fatigue (NMF) in patients with COPD and chronic respiratory failure (CRF) on long-term oxygen therapy (CRF-COPD group), and the relationships between PF, NMF, patient's characteristics, comparing severe patients with COPD to patients without CRF (COPD group).

METHODS

This cross-sectional study compared 19 CRF-COPD patients with 10 COPD patients attending a rehabilitation program. PF was determined by Fatigue Severity Scale (FSS), while dyspnea by the Barthel Dyspnea Index (BDI). We assessed quadriceps NMF via electrical nerve stimulation during and following a Maximal Voluntary Contraction (MVC) detecting changes after a Constant Workload Cycling Test (CWCT) at 80% of the peak power output at exhaustion.

RESULTS

CRF-COPD patients showed higher PF (+ 1.79 of FSS score, p = 0.0052) and dyspnea (+ 21.03 of BDI score, p = 0.0023) than COPD patients. After the fatiguing task and normalization for the total work, there was a similar decrease in the MVC (CRF-COPD -1.5 ± 2.4 vs COPD -1.1 ± 1.2% baseline kJ^-1, p = 0.5819), in the potentiated resting twitch force (CRF-COPD -2.8 ± 4.7 vs COPD -2.0 ± 3.3% baseline kJ^-1, p = 0.7481) and in the maximal voluntary activation (CRF-COPD -0.1 ± 3.9 vs COPD -0.9 ± 1.2 -2.0 ± 3.3% baseline kJ^-1, p = 0.4354). FSS and BDI were closely related (R = 0.5735, p = 0.0011), while no correlation between PF and NMF was found.

CONCLUSION

Patients with CRF-COPD develop higher levels of perceived fatigue and dyspnea than patients with COPD; while neuromuscular fatigue is similar, suggesting a mismatch between symptoms and neuromuscular dysfunction.

A mathematical model for predicting cardiovascular responses at rest and during exercise in demanding environmental conditions

The present research describes the development and validation of a cardiovascular model (CVR Model) for use in conjunction with advanced thermophysiological models, where usually only a total cardiac output is estimated. The CVR Model detailed herein estimates cardio-dynamic parameters (changes in cardiac output, stroke volume, and heart rate), regional blood flow, and muscle oxygen extraction, in response to rest and physical workloads, across a range of ages and aerobic fitness levels, as well as during exposure to heat, dehydration, and altitude. The model development strategy was to first establish basic resting and exercise predictions for cardio-dynamic parameters in an "ideal" environment (cool, sea level, and hydrated person). This basic model was then advanced for increasing levels of altitude, heat strain, and dehydration, using meta-analysis and reaggregation of published data. Using the estimated altitude- and heat-induced changes in maximum oxygen extraction and maximum cardiac output, the decline in maximum oxygen consumption at high altitude and in the heat was also modeled. A validation of predicted cardiovascular strain using heart rate was conducted using a dataset of 101 heterogeneous individuals (1,371 data points) during rest and exercise in the heat and at altitude, demonstrating that the CVR Model performs well (R² = 0.82-0.84) in predicting cardiovascular strain, particularly at a group mean level (R² = 0.97). The development of the CVR Model is aimed at providing the Fiala thermal Physiology & Comfort (FPC) Model and other complex thermophysiological models with improved estimations of cardiac strain and exercise tolerance, across a range of individuals during acute exposure to environmental stressors.NEW & NOTEWORTHY The present research promotes the adaption of thermophysiological modeling to the estimation of cardiovascular strain in individuals exercising under acute environmental stress. Integration with advanced models of human thermoregulation opens doors for detailed numerical analysis of athletes' performance and physiology during exercise, occupational safety, and individual work tolerability. The research provides a simple-to-validate metric of cardiovascular function (heart rate), as well as a method to evaluate key principles influencing exercise- and thermoregulation in humans.

Skeletal Muscle Biochemical Origin of Exercise Intensity Domains and their Relation to Whole-Body V̇O2 Kinetics

This article presents the biochemical intra-skeletal-muscle basis of exercise intensity domains: moderate (M), heavy (H), very heavy (VH) and severe (S). Threshold origins are mediated by a "Pi double-threshold" mechanism of muscle fatigue, which assumes: (1) additional ATP usage, underlying muscle V̇O2 and metabolite slow components, is initiated when inorganic phosphate (Pi) exceeds a critical value (Picrit); (2) exercise is terminated because of fatigue, when Pi reaches a peak value (Pipeak); (3) the Pi increase and additional ATP usage increase mutually stimulate each other forming a positive feedback. M/H and H/VH borders are defined by Pi on-kinetics in relation to Picrit and Pipeak. The values of the ATP usage activity, proportional to power output (PO), for the M/H, H/VH and VH/S borders are lowest in untrained muscle and highest in well-trained muscle. The metabolic range between the M/H and H/VH border (or "H space") decreases with muscle training, while the difference between the H/VH and VH/S border (or "VH space") is only weakly dependent on training status. The absolute magnitude of the muscle V̇O2 slow-component, absent in M exercise, rises gradually with PO to a maximal value in H exercise, and then decreases with PO in VH and S exercise. Simulations of untrained, physically-active and well-trained muscle demonstrate that the muscle M/H border need not be identical to the whole-body M/H border determined from pulmonary V̇O2 on-kinetics and blood lactate, while suggesting that the biochemical origins of the H/VH border reside within skeletal muscle and correspond to whole-body critical power.

A 3-Dimensional Gait Analysis of the Effects of Fatigue-Induced Reduced Foot Adductor Muscle Strength on the Walking of Healthy Subjects

Dysfunction of the tibialis posterior muscle is the most common cause of adult acquired flat foot. Tibialis posterior muscle weakness has been observed in several patient populations, including those in the early stages of rheumatoid arthritis. However, the influence of tibialis posterior weakness on gait mechanics is not fully understood, although gait instability has been reported. In 24 healthy participants, 3-dimension lower limb kinematics and kinetics during walking were evaluated bilaterally, before and after, a muscle fatigue protocol aiming to decrease the right foot adductor muscles strength, including the tibialis posterior muscle. The 3-dimension gait kinematics and kinetics were analyzed with statistical parametric mapping. The stance phase duration was increased for the right side. The right ankle external rotation moment decreased, and the left hip extension moment increased with reduced muscle strength compared with normal strength conditions. These changes are similar in patients with dysfunction in the tibialis posterior muscle, indicating that compensatory strategies observed in these patients might be related to the loss of tibialis posterior muscle strength. Such strategies may involve the unaffected side.

Effects of caffeine ingestion on physiological indexes of human neuromuscular fatigue: A systematic review and meta-analysis

BACKGROUND

Caffeine is often used as a stimulant during fatigue, but the standard of characteristic physiological indicators of the effect of caffeine on neuromuscular fatigue has not been unified. The purpose of this systematic review and meta-analysis is to summarize current experimental findings on the effects of caffeine on physiological indexes before and after neuromuscular fatigue, identify some characteristic neuromuscular physiological indexes to assess the potential effects of caffeine.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-analyses are followed. We systematically searched PubMed, Google academic, and Web of Science for randomized controlled trials. We searched for studies on caffeine's (i) effects on neuromuscular fatigue and (ii) the influence of physiological indexes changes. Meta-analysis was performed for standardized mean differences (SMD) between caffeine and placebo trials in individual studies.

RESULTS

The meta-analysis indicated that caffeine significantly improves voluntary activation (VA) (SMD = 1.46;95%CI:0.13, 2.79; p < .00001), PTw (SMD = 1.11, 95%CI: -1.61, 3.84; p < .00001), and M-wave (SMD = 1.10, 95%CI: -0.21, 2.41; p < .00001), and a significant difference (p = .003) on measures of Peak Power (PP), and insignificant difference on measures of heart rate (HR) (I²  = 0.0, p = .84) and Maximal oxygen uptake (VO₂ ) (I²  = 0.0, p = .76).

CONCLUSION

The analysis showed that caffeine intake had a relatively large effect on VA, potentiated twitch (PTw), M-wave, which can be used as characteristic indexes of caffeine's impact on neuromuscular fatigue. This conclusion tends to indicate the effects of caffeine on neuromuscular fatigue during endurance running or jumping or muscle bending and stretching. The caffeine intake had a big effect on the electromyogram (EMG) and peak power (PP), and its effect role needs to be further verified, this conclusion tends to indicate the effect of caffeine on neuromuscular fatigue during jumping or elbow bending moment movements. HR, VO₂ , maximal voluntary contraction (MVC) cannot be used as the characteristic indexes of caffeine on neuromuscular fatigue. This conclusion tends to indicate the effect of caffeine on neuromuscular fatigue during endurance exercise. However, the results of meta-analysis are based on limited evidence and research scale, as well as individual differences of participants and different physical tasks, so it is necessary to interpret the results of meta-analysis cautiously. Therefore, future research needs to explore other physiological indicators and their indicative effects in order to determine effective and accurate characteristic indicators of caffeine on neuromuscular fatigue.

Hyperoxia Improves Repeated-Sprint Ability and the Associated Training Load in Athletes

This study investigated the impact of hyperoxic gas breathing (HYP) on repeated-sprint ability (RSA) and on the associated training load (TL). Thirteen team- and racquet-sport athletes performed 6-s all-out sprints with 24-s recovery until exhaustion (power decrement ≥ 15% for two consecutive sprints) under normoxic (NOR: F_IO₂ 0.21) and hyperoxic (HYP: F_IO₂ 0.40) conditions in a randomized, single-blind and crossover design. The following variables were recorded throughout the tests: mechanical indices, arterial O₂ saturation (S_pO₂), oxygenation of the vastus lateralis muscle with near-infrared spectroscopy, and electromyographic activity of the vastus lateralis, rectus femoris, and gastrocnemius lateralis muscles. Session TL (work × rate of perceived exertion) and neuromuscular efficiency (work/EMG [Electromyography]) were calculated. Compared with NOR, HYP increased S_pO₂ (2.7 ± 0.8%, Cohen's effect size ES 0.55), the number of sprints (14.5 ± 8.6%, ES 0.28), the total mechanical work (13.6 ± 6.8%, ES 0.30), and the session TL (19.4 ± 7.0%, ES 0.33). Concomitantly, HYP increased the amplitude of muscle oxygenation changes during sprints (25.2 ± 11.7%, ES 0.36) and recovery periods (26.1 ± 11.4%, ES 0.37), as well as muscle recruitment (9.9 ± 12.1%, ES 0.74), and neuromuscular efficiency (6.9 ± 9.0%, ES 0.24). It was concluded that breathing a hyperoxic mixture enriched to 40% O₂ improves the total work performed and the associated training load during an open-loop RSA session in trained athletes. This ergogenic impact may be mediated by metabolic and neuromuscular alterations.

Physiological role of anticipatory cardiorespiratory responses to exercise

This study aimed to investigate whether anticipatory cardiorespiratory responses vary depending on the intensity of the subsequent exercise bout, and whether anticipatory cardiorespiratory adjustments contribute importantly to enhancing exercise performance during high-intensity exercise. Eleven healthy men were provided advance notice of the exercise intensity and a countdown to generate anticipation during 10 min prior to exercise at 0, 50, 80 or 95% maximal work-rate (Experiment 1). A different group of subjects (n = 15) performed a time to exhaustion trial with or without anticipatory countdown (Experiment 2). In Experiment 1, heart rate (HR), oxygen uptake (V_O2 ) and minute ventilation (V_E ) during pre-exercise resting period increased over time and depended on the subsequent exercise intensity. Specifically, there was already a 7.4% increase in HR from more than 5 min prior to the start of exercise at 95% maximal work-rate, followed by progressively augmented increases of 12.5% between 2 and 3 min before exercise, 24.4% between 0 and 1 min before exercise. In Experiment 2, the initial HR for the first 10 s of exercise in the task with anticipation was 11.4% larger compared to without anticipation (p < 0.01), and the difference in HR between the two conditions decreased in a time-dependent manner. In contrast, the initial increases in V_O2 and V_E were significantly lower in the task with anticipation than that without anticipation. The time to exhaustion during high-intensity exercise was 14.6% longer under anticipation condition compared to no anticipation (135 ± 26 s vs. 119 ± 26 s, p = 0.003). In addition, the enhanced exercise performance correlated positively with increased HR response just before and immediately after exercise onset (p < 0.01). These results showed that anticipatory cardiorespiratory adjustments (feedforward control) via the higher brain that operate before starting exercise may play an important role in minimizing the time delay of circulatory response and enhancing performance after onset of high-intensity exercise in man.

Understanding Brain-Skeletal Muscle Crosstalk Impacting Metabolism and Movement

Metabolism and movement, among the critical determinants in the survival and success of an organism, are tightly regulated by the brain and skeletal muscle. At the cellular level, mitochondria -that powers life, and myosin - the molecular motor of the cell, have both evolved to serve this purpose. Although independently, the skeletal muscle and brain have been intensively investigated for over a century, their coordinated involvement in metabolism and movement remains poorly understood. Therefore, a fundamental understanding of the coordinated involvement of the brain and skeletal muscle in metabolism and movement holds great promise in providing a window to a wide range of life processes and in the development of tools and approaches in disease detection and therapy. Recent developments in new tools, technologies and approaches, and advances in computing power and machine learning, provides for the first time the opportunity to establish a new field of study, the 'Science and Engineering of Metabolism and Movement'. This new field of study could provide substantial new insights and breakthrough into how metabolism and movement is governed at the systems level in an organism. The design and approach to accomplish this objective is briefly discussed in this article.

Purinergic signaling as a new mechanism underlying physical exercise benefits: a narrative review

In the last years, it has become evident that both acute and chronic physical exercise trigger responses/adaptations in the purinergic signaling and these adaptations can be considered one important mechanism related to the exercise benefits for health improvement. Purinergic system is composed of enzymes (ectonucleotidases), receptors (P1 and P2 families), and molecules (ATP, ADP, adenosine) that are able to activate these receptors. These components are widely distributed in almost all cell types, and they respond/act in a specific manner depending on the exercise types and/or intensities as well as the cell type (organ/tissue analyzed). For example, while acute intense exercise can be associated with tissue damage, inflammation, and platelet aggregation, chronic exercise exerts anti-inflammatory and anti-aggregant effects, promoting health and/or treating diseases. All of these effects are dependent on the purinergic signaling. Thus, this review was designed to cover the aspects related to the relationship between physical exercise and purinergic signaling, with emphasis on the modulation of ectonucleotidases and receptors. Here, we discuss the impact of different exercise protocols as well as the differences between acute and chronic effects of exercise on the extracellular signaling exerted by purinergic system components. We also reinforce the concept that purinergic signaling must be understood/considered as a mechanism by which exercise exerts its effects.

On the implication of dietary nitrate supplementation for the hemodynamic and fatigue response to cycling exercise

This study investigated the impact of dietary nitrate supplementation on peripheral hemodynamics, the development of neuromuscular fatigue, and time to task failure during cycling exercise. Eleven recreationally active male participants (27 ± 5 yr, V̇o2max: 42 ± 2 mL/kg/min) performed two experimental trials following 3 days of either dietary nitrate-rich beetroot juice (4.1 mmol NO3-/day; DNS) or placebo (PLA) supplementation in a blinded, counterbalanced order. Exercise consisted of constant-load cycling at 50, 75, and 100 W (4 min each) and, at ∼80% of peak power output (218 ± 12 W), to task-failure. All participants returned to repeat the shorter of the two trials performed to task failure, but with the opposite supplementation regime (iso-time comparison; ISO). Mean arterial pressure (MAP), leg blood flow (QL; Doppler ultrasound), leg vascular conductance (LVC), and pulmonary gas exchange were continuously assessed during exercise. Locomotor muscle fatigue was determined by the change in pre to postexercise quadriceps twitch-torque (ΔQtw) and voluntary activation (ΔVA; electrical femoral nerve stimulation). Following DNS, plasma [nitrite] (∼670 vs. ∼180 nmol) and [nitrate] (∼775 vs. ∼11 μmol) were significantly elevated compared with PLA. Unlike PLA, DNS lowered both QL and MAP by ∼8% (P < 0.05), but did not alter LVC (P = 0.31). V̇O2 across work rates, as well as cycling time to task-failure (∼7 min) and locomotor muscle fatigue following the ISO-time comparison were not different between the two conditions (ΔQtw ∼42%, ΔVA ∼4%). Thus, despite significant hemodynamic changes, DNS did not alter the development of locomotor muscle fatigue and, ultimately, cycling time to task failure.NEW & NOTEWORTHY This study sought to characterize the impact of dietary nitrate supplementation on the hemodynamic response, locomotor muscle fatigue, and time to task failure during cycling exercise. Although nitrate supplementation lowered mean arterial pressure and exercising leg blood flow, leg vascular conductance and oxygen utilization were unaffected. Despite significant hemodynamic changes, there was no effect of dietary nitrate on neuromuscular fatigue development and, ultimately, cycling time to task failure.

Fatigability of the knee extensors following high- and low-load resistance exercise sessions in trained men

PURPOSE

Fatigability after gym-based resistance exercises with high and low loads has not been well described, thus limiting the translation of exhaustive low-weight prescription into athletic practice. We compared the fatigability and recovery of the knee extensor muscles for up to 1H after sessions that involved either high- or low-load resistance exercises.

METHODS

16 trained men performed two resistance exercise sessions between 5 and 7 days apart. The LIGHT session involved five sets to task failure at 50% of maximal knee-extension strength, whereas the HEAVY session accrued repetitions across seven sets at intensities ≥ 80% maximal knee-extension strength. Measures of quadriceps maximal torque and rate of torque development were measured before, after, and 1H after each exercise session. Muscle activation (electromyography and voluntary activation) and contractility were measured from doublet stimulation of the femoral nerve during and after maximal contractions, respectively.

RESULTS

Greater declines in maximal rate of torque development were observed after the LIGHT compared with the HEAVY session (p < 0.001), with full recovery after 1H. Voluntary activation (100-Hz doublet stimulation) and surface electromyograms were reduced immediately after the HEAVY session only (p < 0.05), with greater declines in quadriceps twitch amplitudes after the LIGHT session (p < 0.01). Voluntary activation (100-Hz doublet stimulation) was reduced at 1H after both the HEAVY and LIGHT sessions (p < 0.05).

CONCLUSIONS

Despite differences in the decreases in muscle activation and contractility after high- and low-load resistance-exercise sessions, recovery of neuromuscular function was essentially complete after 1H of rest for both sessions.

Physiological complexity: influence of ageing, disease and neuromuscular fatigue on muscle force and torque fluctuations

NEW FINDINGS

What is the topic of this review? Physiological complexity in muscle force and torque fluctuations, specifically the quantification of complexity, how neuromuscular complexityis altered by perturbations and the potential mechanism underlying changes in neuromuscular complexity. What advances does it highlight? The necessity to calculate both magnitude- and complexity-based measures for the thorough evaluation of force/torque fluctuations. Also the need for further research on neuromuscular complexity, particularly how it relates to the performance of functional activities (e.g. manual dexterity, balance, locomotion).

ABSTRACT

Physiological time series produce inherently complex fluctuations. In the last 30 years, methods have been developed to characterise these fluctuations, and have revealed that they contain information about the function of the system producing them. Two broad classes of metrics are used: (1) those which quantify the regularity of the signal (e.g. entropy metrics); and (2) those which quantify the fractal properties of the signal (e.g. detrended fluctuation analysis). Using these techniques, it has been demonstrated that ageing results in a loss of complexity in the time series of a multitude of signals, including heart rate, respiration, gait and, crucially, muscle force or torque output. This suggests that as the body ages, physiological systems become less adaptable (i.e. the systems' ability to respond rapidly to a changing external environment is diminished). More recently, it has been shown that neuromuscular fatigue causes a substantial loss of muscle torque complexity, a process that can be observed in a few minutes, rather than the decades it requires for the same system to degrade with ageing. The loss of torque complexity with neuromuscular fatigue appears to occur exclusively above the critical torque (at least for tasks lasting up to 30 min). The loss of torque complexity can be exacerbated with previous exercise of the same limb, and reduced by the administration of caffeine, suggesting both peripheral and central mechanisms contribute to this loss. The mechanisms underpinning the loss of complexity are not known but may be related to altered motor unit behaviour as the muscle fatigues.

Declines in muscle contractility and activation during isometric contractions of the knee extensors vary with contraction intensity and exercise volume

NEW FINDINGS

What is the central question of this study? Is there a critical threshold beyond which the loss of muscle contractility is regulated by the level of muscle activation during single-limb exercise of differing intensities and volumes? What is the main finding and its importance? Plateaus in the decline in muscle contractility during single-limb knee extension depended on both exercise volume and contraction intensity.  A plateau was only evident with an increase in exercise volume.  Muscle activation increased and did not decline despite substantial reductions in contractility. The findings indicate that the decrease in muscle contractility exhibited by resistance-trained men during the performance of submaximal isometric contractions with the knee extensors was not regulated by the level of muscle activation.

ABSTRACT

Our study examined the influence of contraction intensity and exercise volume on changes in muscle contractility and activation of the knee extensor muscles. Maximal voluntary torque (MVT) and rate of change in torque, surface electromyograms, voluntary activation, V-waves and quadriceps resting twitch measures were assessed in 10 resistance-trained men during two experimental sessions. Each session began with an initial baseline series of contractions at a fixed intensity of 40% or 80% MVT. The 40%-only session continued with five contractions to task failure at 40% MVT. The 80% session continued with five contractions to failure each at 80%, 60% and 40% MVT. Greater reductions in MVT were observed during the baseline contractions of the 40%-only session compared with the 80% session at each matched-volume time point (P < 0.05), with similar changes in twitch values (P < 0.001). MVT and twitch values plateaued at each intensity during the 80% session and were significantly different across intensities: 80% > 60% > 40% (P < 0.001). There were no differences for measures during the five contractions at 40% MVT performed on the different days, despite a greater volume of exercise performed prior to the 40% MVT during the 80% session. At each contraction intensity, a plateau in contractility loss was observed as more contractions were performed. We found that initial increases in muscle activation were maintained in the presence of increases in exercise volume and, in contrast to the critical-threshold hypothesis, did not decline in parallel with reductions in muscle contractility.

Power Reserve at Intolerance in Ramp-Incremental Exercise Is Dependent on Incrementation Rate

INTRODUCTION

The mechanism(s) of exercise intolerance at V˙O2max remain poorly understood. In health, standard ramp-incremental (RI) exercise is limited by fatigue-induced reductions in maximum voluntary cycling power. Whether neuromuscular fatigue also limits exercise when the RI rate is slow and RI peak power at intolerance is lower than standard RI exercise, is unknown.

METHODS

In twelve healthy participants, maximal voluntary cycling power was measured during a short (~6 s) isokinetic effort at 80 rpm (Piso) at baseline and, using an instantaneous switch from cadence-independent to isokinetic cycling, immediately at the limit of RI exercise with RI rates of 50, 25, and 10 W·min-1 (RI-50, RI-25, and RI-10). Breath-by-breath pulmonary gas exchange was measured throughout.

RESULTS

Baseline Piso was not different among RI rates (analysis of variance; P > 0.05). Tolerable duration increased with decreasing RI rate (RI-50, 411 ± 58 s vs RI-25, 732 ± 93 s vs RI-10, 1531 ± 288 s; P < 0.05). At intolerance, V˙O2peak was not different among RI rates (analysis of variance; P > 0.05), but RI peak power decreased with RI rate (RI-50, 361 ± 48 W vs RI-25, 323 ± 39 W vs RI-10, 275 ± 38 W; P < 0.05). Piso at intolerance was 346 ± 43 W, 353 ± 45 W, and 392 ± 69 W for RI-50, RI-25, and RI-10, respectively (P < 0.05 for RI-10 vs RI-50 and RI-25). At intolerance, in RI-50 and RI-25, Piso was not different from RI peak power (P > 0.05), thus there was no "power reserve." In RI-10, Piso was greater than RI peak power at intolerance (P < 0.001), that is, there was a "power reserve."

CONCLUSIONS

In RI-50 and RI-25, the absence of a power reserve suggests the neuromuscular fatigue-induced reduction in Piso coincided with V˙O2max and limited the exercise. In RI-10, the power reserve suggests neuromuscular fatigue was insufficient to limit the exercise, and additional mechanisms contributed to intolerance at V˙O2max.

Perceived mental strain dissociates from perceived physical strain during relative intensity submaximal exercise on ascent from low to high altitude

Perceived fatigability, which has perception of physical strain and of mental strain as its components, can impact exercise tolerance. Upon ascent to high altitude, low landers experience reduced exercise capacity and reduced tolerance for a given absolute submaximal work rate. It is established that perceived physical strain tracks with relative exercise intensity. However, it is not known how altitude ascent affects perceived mental strain relative to perceived physical strain. We tested the hypothesis that when exercising at the same relative exercise intensity perceived physical strain will remain unchanged whereas perceived mental strain will decrease on ascent from low to high altitude in the Everest region in Nepal. Twelve hours after arriving at each of three elevations; 1400 m, 3440 m, and 4240 m, 12 untrained participants used the task effort awareness (TEA) and physical-rating of perceived exertion (P-RPE) scales to report perceived mental and physical strain during a 20 min walking test at a self-monitored heart rate reserve (HRR) range of 40-60% (Polar HR Monitor). TEA and P-RPE were recorded twice during exercise (5-7 min and 14-16 min). Neither P-RPE (1400 m: 11.1 ± 1.8, 3440 m: 10.7 ± 1.2, 4240 m: 11.5 ± 1.5) nor %HRR (1400 m: 55.25 ± 7.34, 3440 m: 51.70 ± 6.70, 4240 m: 50.17 ± 4.02) changed as altitude increased. TEA decreased at 4240 m (2.05 ± 0.71) compared to 1400 m (3.44 ± 0.84)--this change was not correlated with any change in %HRR nor was it due to a change in core affect. These findings support our hypothesis and demonstrate the independence of perceived physical and perceived mental strain components of perceived fatigability. Implications for exercise tolerance remain to be determined.

Impact of a Season of Bike Patrol on Police Officers' Level of Fitness: A Pilot Study

Bike patrollers must have a good level of fitness to perform their patrolling duties adequately and effectively by bike and accomplish specific work tasks, which may require the use of various physical capacities. However, there is little information on the real workload associated with bike patrol and its impact on health. The purpose of this study was to assess the general physical fitness of police officers before and after a season of bike patrolling and then quantify its effects on each patroller’s health. All six male police officers (29.5 ± 4.3 years old) performed two complete physical fitness evaluations (PRE- and POST-season), which included anthropometric measurements (weight, waist circumference, and body mass index), a push-up test, a sit-up test, a grip strength test, a vertical jump test, a sit-and-reach test, and an aerobic capacity test on a bicycle ergometer. Paired t-tests were used to evaluate the differences in test performance between the PRE- and POST-season. Grip strength, estimated VO₂max, and power deployed on the bike all showed significant improvement after the season (p-value 0.0133; 0.007; and 0.003, respectively). No significant differences were found among the evaluation’s other components (p > 0.05). Results show the workload associated with a bike patrol season caused a considerable improvement in grip strength, VO₂max, and power deployed on the bike, and might be beneficial for their overall health as a work-integrated avenue to keep the officers fit for duty. Further research on the subject is suggested.

Slight power output manipulations around the maximal lactate steady state have a similar impact on fatigue in females and males

Neuromuscular fatigue (NMF) and exercise performance are affected by exercise intensity and sex differences. However, whether slight changes in power output (PO) below and above the maximal lactate steady state (MLSS) impact NMF and subsequent performance (time to task failure, TTF) is unknown. This study compared NMF and TTF in females and males in response to exercise performed at MLSS, 10 W below (MLSS_-10) and above (MLSS₊₁₀). Twenty participants (9 females) performed three 30-min constant-PO exercise bouts followed (1-min delay) by a TTF at 80% of the peak-PO. NMF was characterized by isometric maximal voluntary contractions (IMVC) and femoral nerve electrical stimulation of knee extensors [e.g., peak torque of potentiated high-frequency (Db100) and single twitch (TwPt)] before and immediately after the constant-PO and TTF bouts. IMVC declined less after MLSS_-10 (-18 ± 10%) compared to MLSS (-26 ± 14%) and MLSS₊₁₀ (-31 ± 11%; all P < 0.05), and the Db100 decline was greater after MLSS₊₁₀ (-24 ± 14%) compared to the other intensities (MLSS_-10: -15 ± 9%; MLSS: -18 ± 11%; all P < 0.05). Females showed smaller reductions, relative to baseline, in IMVC and TwPt compared to males after constant-PO bouts (all P < 0.05), this difference being not dependent on intensity. TTF was negatively impacted by increasing the PO in the constant-PO (P < 0.001), with no differences in end-exercise NMF (P > 0.05). Slight manipulations in PO around MLSS elicited great changes in the reduction of maximal voluntary force and impairments in contractile function. Although NMF was lower in females compared to males, the changes in PO around the MLSS impacted both sexes similarly.NEW & NOTEWORTHY It is unknown whether minimum changes in power output (PO) below and above the maximal lactate steady state (MLSS) affect neuromuscular fatigue (NMF) development in females and males. The present data showed that a decrease or increase of 10 W in PO in relation to MLSS elicited lower and greater impairments in contractile function, respectively. Even though females had less of an overall decline in NMF than males, similar exercise intensity-dependent response occurred independently of sex.

Distinct pacing profiles result in similar perceptual responses and neuromuscular fatigue development: Why different "roads" finish at the same line?

ABSTRACTThe current study analysed the effect of distinct pacing profiles (i.e. U, J, and inverted J) in the perceptual responses and neuromuscular fatigue (NMF) development following a 4-km cycling time trial (TT). Twenty-one cyclists with similar training status were allocated into three different groups based on their pacing profile spontaneously adopted during TT. Rating of perceived exertion (RPE), oxygen uptake (⩒O₂) and heart rate (HR) were continuously recorded. NMF was assessed by using isometric maximal voluntary contractions (IMVC), while the central [i.e. voluntary activation (VA)] and peripheral fatigue of knee extensors [i.e. peak torque of potentiated twitches (TwPt)] were evaluated using electrically evoked contractions performed pre and 2 min after the TT. TT performance was not different amongst pacing profiles (U = 377 ± 20 s; J = 392 ± 23 s; J-i = 381 ± 20 s) (all P > 0.05). RPE, ⩒O₂ and HR increased similarly throughout the TT regardless the pacing strategy (all P > 0.05). Similarly, IMVC (U = -9.9 ± 8.8; J = -9.6 ± 4.5%; J-i = -13.8 ± 11.3%), VA (U = -2.3 ± 1.7%; J = -5.4 ± 2.2%; J-i = -6.4 ± 4.5%) and TwPt (U = -32.5 ± 12.0%; J = -29.5 ± 8.0%; J-i = -33.6 ± 13.6%) were similar amongst pacing profiles (all P > 0.05). Therefore, endurance athletes with similar training status showed the same perceived responses and NMF development regardless the pacing profile spontaneously adopted. It was suggested that these responses occurred in order to preserve a similar rate of change in systemic responses (i.e. RPE, ⩒O₂ and HR) and NMF development, ultimately resulting in same TT performance.Highlights Different pacing profiles resulted in the same performance in a 4-km cycling time trial.The similar performance might be due to achievement of the same sensory tolerance limit.There was no difference for perceptual, metabolic and neuromuscular fatigue responses.

Recovery from Fatigue after Cycling Time Trials in Elite Endurance Athletes

INTRODUCTION

We determined the recovery from neuromuscular fatigue in six professional (PRO) and seven moderately trained (MOD) cyclists after repeated cycling time trials of various intensities/durations.

METHOD

Participants performed two 1-min (1minTT) or two 10-min (10minTT) self-paced cycling time trials with 5 min of recovery in between. Central and peripheral fatigue were quantified via preexercise to postexercise (15-s through 15-min recovery) changes in voluntary activation (VA) and potentiated twitch force. VA was measured using the interpolated twitch technique, and potentiated twitch force was evoked by single (QTsingle) and paired (10-Hz (QT10) and 100-Hz (QT100)) electrical stimulations of the femoral nerve.

RESULTS

Mean power output was 32%-72% higher during all the time trials and decreased less (-10% vs -13%) from the first to second time trial in PRO compared with MOD (P < 0.05). Conversely, exercise-induced reduction in QTsingle and QT10/QT100 was significantly lower in PRO after every time trial (P < 0.05). Recovery from fatigue from 15 s to 2 min for QTsingle and QT10/QT100 was slower in PRO after every time trial (P < 0.05). In both groups, the reduction in QTsingle was lower after the 10minTTs compared with 1minTTs (P < 0.05). Conversely, VA decreased more after the 10minTTs compared with 1minTTs (P < 0.05).

CONCLUSION

Our findings showed that excitation-contraction coupling was preserved after exercise in PRO compared with MOD. This likely contributed to the improved performance during repeated cycling time trials of various intensity/duration in PRO, despite a slower rate of recovery in its early phase. Finally, the time course of recovery from neuromuscular fatigue in PRO was dependent on the effects of prolonged low-frequency force depression.

An Abductive Inference Approach to Assess the Performance-Enhancing Effects of Drugs Included on the World Anti-Doping Agency Prohibited List

Some have questioned the evidence for performance-enhancing effects of several substances included on the World Anti-Doping Agency's Prohibited List due to the divergent or inconclusive findings in randomized controlled trials (RCTs). However, inductive statistical inference based on RCTs-only may result in biased conclusions because of the scarcity of studies, inter-study heterogeneity, too few outcome events, or insufficient power. An abductive inference approach, where the body of evidence is evaluated beyond considerations of statistical significance, may serve as a tool to assess the plausibility of performance-enhancing effects of substances by also considering observations and facts not solely obtained from RCTs. Herein, we explored the applicability of an abductive inference approach as a tool to assess the performance-enhancing effects of substances included on the Prohibited List. We applied an abductive inference approach to make inferences on debated issues pertaining to the ergogenic effects of recombinant human erythropoietin (rHuEPO), beta₂-agonists and anabolic androgenic steroids (AAS), and extended the approach to more controversial drug classes where RCTs are limited. We report that an abductive inference approach is a useful tool to assess the ergogenic effect of substances included on the Prohibited List-particularly for substances where inductive inference is inconclusive. Specifically, a systematic abductive inference approach can aid researchers in assessing the effects of doping substances, either by leading to suggestions of causal relationships or identifying the need for additional research.

Quantification of Neuromuscular Fatigue: What Do We Do Wrong and Why?

Neuromuscular fatigue (NMF) is usually assessed non-invasively in healthy, athletic or clinical populations with the combination of voluntary and evoked contractions. Although it might appear relatively straightforward to magnetically or electrically stimulate at different levels (cortical/spinal/muscle) and to measure mechanical and electromyographic responses to quantify neuromuscular adjustments due to sustained/repeated muscle contractions, there are drawbacks that researchers and clinicians need to bear in mind. The aim of this opinion paper is to highlight the pitfalls inevitably faced when NMF is quantified. The first problem might arise from the definition of fatigue itself and the parameter(s) used to measure it; for instance, measuring power vs. isometric torque may lead to different conclusions. Another potential limitation is the delay between exercise termination and the evaluation of neuromuscular function; the possible underestimation of exercise-induced neural and contractile impairment and misinterpretation of fatigue etiology will be discussed, as well as solutions recently proposed to overcome this problem. Quantification of NMF can also be biased (or not feasible) because of the techniques themselves (e.g. results may depend on stimulation intensity for transcranial magnetic stimulation) or the way data are analyzed (e.g. M wave peak-to-peak vs first phase amplitude). When available, alternatives recently suggested in the literature to overcome these pitfalls are considered and recommendations about the best practices to assess NMF (e.g. paying attention to the delay between exercise and testing, adapting the method to the characteristics of the population to be tested and considering the limitations associated with the techniques) are proposed.

Dynamic Changes of Performance Fatigability and Muscular O2 Saturation in a 4-km Cycling Time Trial

PURPOSE

The current study characterized the performance fatigability etiology, immediately after exercise cessation, and its relation to the dynamic changes in muscle O2 saturation (SmO2) at different TT phases.

METHODS

Twelve males performed three separated TT of different distances, in a crossover counterbalanced design, until the end of the fast-start (FS, 827 ± 135 m), even-pace (EP, 3590 ± 66 m), or end-spurt (ES, 4000 m) TT phases. Performance fatigability was characterized by using isometric maximal voluntary contractions (IMVC), whereas the maximal voluntary activation (VA) and contractile function of knee extensors (e.g., peak torque of potentiated twitches [TwPt]) were evaluated using electrically evoked contractions performed before and immediately after each exercise bouts. SmO2, power output (PO), and EMG were also recorded.

RESULTS

Immediately after the FS phase, there were lower values for IMVC (-23%), VA (-8%), and TwPt (-43%) (all P < 0.001), but no further changes were measured after EP (IMVC, -28%; VA, -8%; TwPt, -38%). After the ES phase, IMVC (-34%) and TwPt (-59%) further decreased compared with the previous phases (P < 0.05). There were lower SmO2 and higher EMG/PO values during FS and ES compared with EP phase.

CONCLUSION

FS and EP phases had similar performance fatigability etiology, but ES showed further impairments in contractile function. This later finding might be due to the abrupt changes in SmO2 and EMG/PO because of the high exercise intensity during the ES, which elicited maximal decline in contractile function at the finish line.

The effect of blood-flow-restricted interval training on lactate and H+ dynamics during dynamic exercise in man

AIM

To assess how blood-flow-restricted (BFR) interval-training affects the capacity of the leg muscles for pH regulation during dynamic exercise in physically trained men.

METHODS

Ten men (age: 25 ± 4y; V ˙ O 2 max : 50 ± 5 mL∙kg^-1 ∙min^-1 ) completed a 6-wk interval-cycling intervention (INT) with one leg under BFR (BFR-leg; ~180 mmHg) and the other without BFR (CON-leg). Before and after INT, thigh net H⁺ -release (lactate-dependent, lactate-independent and sum) and blood acid/base variables were measured during knee-extensor exercise at 25% (Ex25) and 90% (Ex90) of incremental peak power output. A muscle biopsy was collected before and after Ex90 to determine pH, lactate and density of H⁺ -transport/buffering systems.

RESULTS

After INT, net H⁺ release (BFR-leg: 15 ± 2; CON-leg: 13 ± 3; mmol·min^-1 ; Mean ± 95% CI), net lactate-independent H⁺ release (BFR-leg: 8 ± 1; CON-leg: 4 ± 1; mmol·min^-1 ) and net lactate-dependent H⁺ release (BFR-leg: 9 ± 3; CON-leg: 10 ± 3; mmol·min^-1 ) were similar between legs during Ex90 (P > .05), despite a ~142% lower muscle intracellular-to-interstitial lactate gradient in BFR-leg (-3 ± 4 vs 6 ± 6 mmol·L^-1 ; P < .05). In recovery from Ex90, net lactate-dependent H⁺ efflux decreased in BFR-leg with INT (P < .05 vs CON-leg) owing to lowered muscle lactate production (~58% vs CON-leg, P < .05). Net H⁺ gradient was not different between legs (~19%, P > .05; BFR-leg: 48 ± 30; CON-leg: 44 ± 23; mmol·L^-1 ). In BFR-leg, NHE1 density was higher than in CON-leg (~45%; P < .05) and correlated with total-net H⁺ -release (r = 0.71; P = .031) and lactate-independent H⁺ release (r = 0.74; P = .023) after INT, where arterial [ HCO 3 - ] and standard base excess in Ex25 were higher in BFR-leg than CON-leg.

CONCLUSION

Compared to a training control, BFR-interval training increases the capacity for pH regulation during dynamic exercise mainly via enhancement of muscle lactate-dependent H⁺ -transport function and blood H⁺ -buffering capacity.

Neuromuscular responses to fatiguing locomotor exercise

Over the last two decades, an abundance of research has explored the impact of fatiguing locomotor exercise on the neuromuscular system. Neurostimulation techniques have been implemented prior to and following locomotor exercise tasks of a wide variety of intensities, durations, and modes. These techniques have allowed for the assessment of alterations occurring within the central nervous system and the muscle, while techniques such as transcranial magnetic stimulation and spinal electrical stimulation have permitted further segmentalization of locomotor exercise-induced changes along the motor pathway. To this end, the present review provides a comprehensive synopsis of the literature pertaining to neuromuscular responses to locomotor exercise. Sections of the review were divided to discuss neuromuscular responses to maximal, severe, heavy and moderate intensity, high-intensity intermittent exercise, and differences in neuromuscular responses between exercise modalities. During maximal and severe intensity exercise, alterations in neuromuscular function reside primarily within the muscle. Although post-exercise reductions in voluntary activation following maximal and severe intensity exercise are generally modest, several studies have observed alterations occurring at the cortical and/or spinal level. During prolonged heavy and moderate intensity exercise, impairments in contractile function are attenuated with respect to severe intensity exercise, but are still widely observed. While reductions in voluntary activation are greater during heavy and moderate intensity exercise, the specific alterations occurring within the central nervous system remain unclear. Further work utilizing stimulation techniques during exercise and integrating new and emerging techniques such as high-density electromyography is warranted to provide further insight into neuromuscular responses to locomotor exercise.

Impact of Weekly Physical Activity on Stress Response: An Experimental Study

The aim of this research is focused on analyzing the alteration of the psychophysiological and cognitive response to an objective computerized stress test (Determination Test - DT-, Vienna test System^®), when the behavioral response is controlled. The sample used was sports science students (N = 22), with a mean age of 22.82 (M_age = 22.82; SD_years = 3.67; M_{PhysicalActivity hours/Week} = 7.77; SD_hours/_week = 3.32) A quasi-experimental design was used in which the response of each participant to the DT test was evaluated. The variable “number of hours of physical activity per week” and the variable “level of behavioral response to stress” were controlled. Before and after this test, the following parameters were measured: activation and central fatigue (Critical Flicker Fusion Threshold (CFF Critical flicker fusion ascending and Critical flicker fusion descending; DC potential), and perceived exertion (Central Rating of Perceived Exertion and Peripheral Rating of Perceived Exertion). Significant differences were found in all of the measures indicated. The usefulness of this protocol and the measures used to analyze the stress response capacity of the study subjects are discussed.

Muscle Fatigability After Hex-Bar Deadlift Exercise Performed With Fast or Slow Tempo

Purpose: To examine the differences in muscle fatigability after resistance exercise performed with fast tempo (FT) compared with slow tempo (ST). Methods: A total of 8 resistance-trained males completed FT and ST hexagonal-barbell deadlifts, consisting of 8 sets of 6 repetitions at 60% 3-repetition maximum, using a randomized crossover design. Each FT repetition was performed with maximal velocity, while each repetition during ST was performed with a 3-1-3 (eccentric/isometric/concentric) tempo (measured in seconds). Isometric maximal voluntary contraction, voluntary muscle activation, and evoked potentiated twitch torque of the knee extensors were determined using twitch interpolation before, during (set 4), and after exercise. Displacement–time data were measured during the protocols. Results: The mean bar velocity and total concentric work were higher for FT compared with ST (995 [166] W vs 233 [52] W; 0.87 [0.05] m/s vs 0.19 [0.05] m/s; 4.8 [0.8] kJ vs 3.7 [1.1] kJ). Maximal voluntary contraction torque, potentiated twitch, and voluntary muscle activation were significantly reduced after FT (−7.8% [9.2%]; −5.2% [9.2%], −8.7% [12.2%]) and ST (−11.2% [8.4%], −13.3% [8.1%], −1.8% [3.6%]). Conclusion: The decline in maximal voluntary force after both the FT and ST hexagonal-barbell deadlifts exercise was accompanied by a similar decline in contractile force and voluntary muscle activation.

The Relationship on Exercise Anticipation, Function and Self-efficacy in Patients After Knee Surgeries Over Six Months: An Observational Study

AIM

To explore the association between the exercise anticipation, function and self-efficacy in patients after knee surgeries over six months and to identify the predictors for rehabilitation.

METHODS

This observational study used the cross-sectional survey method and was divided into two stages: (1) designing the experimental video materials and answer cards about exercise anticipation, and (2) analyzing the correlation of the level of exercise anticipation, knee function, modified gait efficacy scale (mGES), self-efficacy for rehabilitation outcome scale (SER), self-efficacy for exercise scale (SEE), time up and go task (TUG) and knee joint angle in walking. We used IBM SPSS modeler 18.0 software for establishing the Bayesian network data mining model, which can identify strong positive and negative associations.

RESULTS

A total of 110 patients were included in this study. Our research confirmed that the exercise anticipation score exhibited the significant correlation with SER (r=0.552, P<0.01), SEE (r=0.457, P<0.01), TUG (r=-0.419, P<0.01) and knee joint angle in walking (r=-0.342, P<0.01). There is only one parent node of exercise expectation, that is, rehabilitation self-efficacy, which shows that the rehabilitation self-efficacy of patients after knee surgery is directly related to their ability to judge exercise expectation. Meanwhile this study verified the model results, and the area under the ROC curve (AUC) is 0.572 (755/1320), indicating that the prediction performance is acceptable.

CONCLUSION

This preliminary study confirmed that improving the exercise anticipation and rehabilitation self-efficacy is an important method of enhancing the knee function in patients after knee surgeries over six months. In the future, the long-term effect of the exercise anticipation and self-efficacy should be researched.

Effects of Maximal vs. Submaximal Isometric Fatiguing Exercise on Subsequent Submaximal Exercise Performance

Miller, WM, Ye, X, and Jeon, S. Effects of maximal vs. submaximal isometric fatiguing exercise on subsequent submaximal exercise performance. J Strength Cond Res 34(7): 1875-1883, 2020-Exercise-induced muscle fatigue directly influences subsequent exercise performance. Thus, we examined task failure times for submaximal intermittent fatiguing isometric contractions performed after a bout of sustained maximal vs. submaximal isometric fatiguing contractions with the dominant elbow flexors. Twenty physically active individuals 8 men (mean ± SD = 21.4 ± 1.8 years; 80.9 ± 12.5 kg; 180 ± 6.4 cm) and 12 women (mean ± SD = 21.4 ± 2.7; 66.8 ± 15.6 kg; 165.7 ± 7.1 cm) participated in a 3-visit randomized cross-over study. Visit 1 included familiarization, and 2 and 3 were randomized for sustained maximal (until force was below 50% of the maximal force value) or submaximal conditions (50% of maximal force until task failure), followed by submaximal intermittent isometric contractions to task failure. Surface electromyography was recorded through the biceps brachii during all fatiguing contractions. Task failure time was significantly shorter for the maximal compared with submaximal condition, and no significant difference in sex or condition was found for the subsequent fatiguing condition. Electromyography amplitude significantly increased in the submaximal intermittent isometric contractions from prefatigue and first and final postfatigue with no condition or sex differences. Electromyography mean frequency significantly decreased from prefatigue and first and final postfatigue for both sexes, with no condition or sex differences. With both maximal and submaximal exercises inducing the same level of force deficit, our results suggested that both exercises might have imposed a similar burden on the neuromuscular system, thereby not providing differential effects on the subsequent submaximal exercise performance.